Individual provider Active NPI

Brian Heenan

  • Clinical Social Worker
  • Appleton, WI
National Provider Identifier
1669062576
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC200003344 Issued in DC
Practice address
3825 E Calumet St Ste 400-255
Appleton, WI 54915-4159
Phone
(202) 810-9212
NPI assigned
Jan 25, 2021
Last updated
Oct 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC200003344 DC Primary
Clinical Social Worker 1041C0700X 12093-123 WI

Addresses

Primary practice location

3825 E Calumet St Ste 400-255
Appleton, WI 54915-4159

Mailing address

1835 E Edgewood Dr Ste 105107
Appleton, WI 54913-9407
Phone (920) 234-6842

Other practice location 1

1835 E Edgewood Dr Ste 105107
Appleton, WI 54913-9407
Phone (920) 234-6842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250807003341 WI Practitioner - Clinical Social Worker 8628576865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mend Counseling LLCGroup PAC ID 0840724522, 9 clinicians

Practice addresses (Care Compare)

1835 E Edgewood Dr
Suite 105107
Appleton, WI 54913-9407
Phone (920) 234-6842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC200003344DCMDClinical Social Worker
12093-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mend Counseling LLC CurrentSince May 12, 2025 Accepting new patients
Be Curious LLC Clinical CurrentSince May 1, 2023 Accepting new patients
Kelly Haines & Associates, LLC Clinical PastSince Jan 1, 2021 Accepting new patients

Locations

2000 P St NW
Ste 630
Washington, DC 20036
Phone (202) 394-5091

1835 E Edgewood Dr
Ste 105107
Appleton, WI 54913
Phone (920) 234-6842

3825 E Calumet St
Ste 400255
Appleton, WI 54915
Phone (202) 810-9212

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1669062576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 E EDGEWOOD DR STE 105107",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139407",
            "telephone_number": "920-234-6842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 E CALUMET ST STE 400-255",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549154159",
            "telephone_number": "202-810-9212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1835 E Edgewood Dr Ste 105107",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549139407",
            "country_code": "US",
            "telephone_number": "920-234-6842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEENAN",
        "first_name": "BRIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-25",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200003344",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "12093-123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.